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Individual

JOHN A RAYMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1465 E PARKDALE AVE, MANISTEE, MI 49660-9709
(231) 723-1147
(231) 398-1427
Mailing address
PO BOX 315, CADILLAC, MI 49601-0315
(231) 775-7405
(231) 775-0027

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
4301036632
MI
2085R0202X
Diagnostic Radiology Physician
Primary
4301036632
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104475226
MI
Enumeration date
06/28/2006
Last updated
09/22/2016
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